[Reconsideration and desire for tubal recanalization in women following voluntary sterilization]. / Pentimento e desiderio di ricanalizzazione tubarica dopo sterilizzazione volontaria nella donna.

PIP: More than 100 million people globally have resorted to voluntary sterilization to limit their fertility. Often negative psychological complications manifest themselves, such as depressive and remorseful feelings. The requests for tubal recanalization ranged from 1.3% to 15% according to the findings of 22 studies published between 1949 and 1969. The regret over the loss of fertility was higher among women with fewer than 4 children and among those who were sterilized after abortion. The maximum incidence of regret of 10-15% was reported in a 1959 study, and the lowest rates were reported in 1967 (1.3%) and in 1970 (2%). A review of 846 Puerto Rican women aged 15-49 years indicated a certain degree of regret in 21% and profound dissatisfaction in 11%, mainly because of young age and new partner. 25% of 497 subjects in a 1985 Montreal survey expressly requested the restoration of their fertility. Similar results were reported in a Danish study following up 547 cases of female sterilization during an observation period of 50 months. The international literature makes apparent that sterilization can be considered definitive mutilation in certain cases, which raises the question whether the woman who intends to undergo the operation possesses the intellectual, psychological, interpersonal, and social resources to make such a decision. Only absolutely freely chosen, voluntary sterilization can prevent consequences.^ieng

[Effectiveness of transdermal administration of 17-beta-estradiol in the management of menopause]. / Efficacia del 17-beta-estradiolo per via transdermica nel trattamento della menopausa.

Seventeen-beta-estradiol administered via a transdermic route was used to treat menopausal symptoms. The results obtained demonstrate the drug's good level of tolerability and considerable efficacy.

[Psychosexual implications of female sterilization]. / Problemi psicosessuali connessi alla sterilizzazione femminile.

PIP: According to data of the Italian Association for Demographic Education, from 1978 to 1991 a total of 16,000 sterilizations were carried out in patients with an average age of 36 years. There was an increasing frequency of anxiety, depression, and lack of satisfaction with sexual life, and deterioration of marital life as the consequence of the operations. Psychological improvement has been reported in only a few cases. Hysterectomy, mastectomy, abortion, and sterilization produce profound psychological effects in women. The ideal candidate for such intervention should be fully aware of the choice and be well informed about the reproductive system, and aged over 30 with at least 2 children in a stable marital relationship. A 1973 review of 80 different studies carried out in 12 different countries reported that 82% of women benefited from the operation. In a study of 180 patients in Glasgow, Scotland, psychosexual disorders were found, in only 3.6%. In a 1975 report, postoperative psychiatric disturbances in sexual life were recorded in 2% of 98 women. Another study of 94 women who were sterilized did not find any medical or psychological problems but did find patients who were completely satisfied 2 years later. In a study of 50 patients who underwent surgical sterilization by the Pomeroy technique during cesarean section, sexual behavior in the women, measured as desire, frequency of intercourse, and satisfaction, was unchanged in 47, while in 3 there were only modest variations in libido and frequency of intercourse. On the basis of these reports in the majority of cases the outcome of sterilization was favorable when assessing various gynecological problems over time. On the other hand, when the candidate is a young woman the information has to be particularly detailed and scrupulous with respect to risks and the probable irreversibility of sterilization.^ieng